Arra Yerganian: How Social Determinants of Health Impact the Consumer Journey
Five-time Chief Marketing/Brand Officer Arra Yerganian thinks healthcare has always been “a little upside down” — controlled by physicians instead of patients.
"Your zip code has more to do with your health than your genetic code."
By E.B. Moss
As someone who describes himself as a “customer experience evangelist,” Arra Yerganian is on a mission to raise awareness of the Social Determinants of Health and how the changing world of data-driven marketing can smooth the bumps on our communal journey to better living.
What are the Social Determinants Of Health, and how do they fit this into the world of marketing?
SDOH is sort of a technical way to think about one's longevity as it relates to the environment. For the first time your zip code is more directly related to your longevity than your genetic code. That means access to things like great medical care, clean air, nutritious foods, education, safe gun-free zones, will dictate for many how our lives will play out. What's sad today is that so many don't have access to these basic necessities. And we're talking about the United States of America—even in major metropolitan areas.
We’re at this critical juncture, I think, both economically and within our society, around how we take advantage of the gifts we have as individuals who are more privileged, per se, and how we give back to the communities that don’t have the same means. If you think it only affects those communities, think differently. Imagine the people that you interact with who may or may not be vaccinated or getting the right sorts of treatment and then, lo and behold, exposing you to disease states or conditions—and not because you weren’t careful about your own self but because you didn’t necessarily help those who are less advantaged. Then sure enough, that affliction translates to you and into your community and to the places that you think you wouldn’t imagine seeing these same sorts of challenges.
So, the big opportunity here is for us to think differently and really embrace Social Determinants of Health.
Are there any new approaches in health and wellness and the marketing of it that help?
This new wave of telehealth and telemedicine enables individuals to get the access they need in a frictionless way. It’s funny: I spent several years as CMO of Sutter Health and of One Medical and I used to talk about creating a frictionless experience. What that meant to me then was to be available when the person needs or wants that care and make it affordable and provided in a way that meets the needs and demands of that individual; to democratize healthcare.
Healthcare has always been a bit upside down—typically controlled by physicians and physician leaders who put the person in a different sort of place in that continuum. (In fact, one of the things I did [as CMO] was ban the word “patient” because it stems from the Latin for “a place of suffering.” That should be a temporary state at best.)
There are great practitioners who care deeply about your care, but they often get swallowed up by a system that requires them to see 35 people a day for maybe three minutes each. This connection between brand and demand has, I think, helped change the conversation, to put the consumer now at the forefront of that service model. Why not let telehealth take the burden away from those providers and create a situation where there's an incentive for that provider to provide great care?
“One of the things I did as CMO was ban the word ‘patient’ because it stems from the Latin for ‘a place of suffering.’ That should be a temporary state.”
Words are powerful. What did you replace the word “patient” with, and how did you push that thinking out across your broader organization?
At One Medical, we called them “members” and we used their name, so it wasn't a dehumanizing experience to come into the doctor's office. I think that is transformative unto itself.
It's become second nature for us to refer to the “patient experience.” I think we have to think about it as a customer journey—as if you were in any fine restaurant or hotel, when you're often thanked for your visit and they use your name. When you leave a hospital, you're “discharged.” It's another word that I banned. It sounds so technical and so cold.
If we're thinking about this concept of brand and demand as it relates to health care, in order for there to be demand, there needs to be a brand essence, a value proposition that really matters to the individuals who are being cared for. So they return because, again, consumers have choice. Hopefully the consumerization of healthcare, and telehealth, is helping change the paradigm.
What is the messaging around SDOH and how is data on its impact on communities being applied?
This is the challenge. It certainly starts with education, when kids are in elementary school, with nutrition programs in class. It starts with diet and exercise. It can’t just be one without the other, throughout our lives. But we're in a quandary today with COVID-19 when kids haven't been to school since last March. And it becomes more of a challenge for individuals who don't have parents who can ensure that they're getting balanced meals throughout the day, or young adults who don't necessarily have the means to [shop for] nutritious meals.
[One approach is] value-based programs that can reward healthcare providers with incentive payments for providing quality of care. The large health systems must really value the relationship with the person that they're providing care to. I think that's a critical element to the continuum. If you can get healthcare workers to go to a community center and bring people in and share with them, particularly the parents, the impact that their choices make on their kids’ long-term health, that might be the dose of medicine, so to speak, that cracks the code.
[Data-wise] I think we have enough of a multi-generational view to know that these individuals, parents, perhaps siblings of the parents, have died prematurely because of the lack of things we’ve talked about.
All of these elements play a role, hopefully, in changing behavior because it’s ultimately going to be an educational exercise and a behavioral change exercise.
How can products or brands, like a sleep aid or a gym facility, leverage some healthcare data and apply that to their marketing as well?
Well, I'm conscious of my sleep and I'm wearing a fitness tracker right now as well. They provide lots of feedback around the type of experience we have throughout our lives. So I think that data will ultimately provide great insight. Then that should be communicated through the healthcare service or provider network so that the data really helps prove in an indisputable way that your behavior, the actions you take, will have an impact on your life and your life's course.
Education is what ultimately will help individuals recognize that a behavioral shift needs to take place. And if in fact enough information is disseminated, then I think individuals will start taking seriously the challenges that perhaps they've overlooked throughout their lives.
Is there a need to manage privacy concerns around all of that personal data -- that it could influence my purchases or my care?
There's an underlying privacy concern with us about everything that we do today. Companies and organizations are getting smarter about the way they're tracking and managing the data they have. Fifteen years ago, I would have been very reluctant to give my credit card number to a website where there's no live person or a bit of a relationship and trust. Today we hand out our credit card information as we're shopping like it's candy. Yes, there'll be periodic breaches, but as long as organizations are learning as they continue to grow and mature, we'll all be better off with this data dissemination.
Overall, where do you fall on the brand and demand continuum?
I think two things have to happen before an organization leverages their brand or any real marketing activity takes place: Number one, the product has to be absolutely awesome. And two -- and maybe even more importantly—that customer journey has got to be second to none. It has to have opportunities where individuals engage in a meaningful way. Then I think a brand has the right to go out there and market effectively.
How do you market against patients deferring to Google for diagnosing themselves versus going to the doctor?
I think the stat is more than two thirds of the individuals who enter the session with their physician have already done [online] research on conditions. Information is absolutely the great equalizer and shows that they care. It opens up that door to ‘How can we help you live a better life?’ Because at the end of the day I want individuals to remain consumers of life substantially longer than they become consumers of healthcare. We realize that health insurers want that too.
Can you share any examples of good marketing meeting good performance in healthcare?
There's a wonderful program called Silver Sneakers that when you become Medicare eligible at the age of 65, you're offered typically for free. And the reason why Humana and Aetna and the Blues, etcetera, are so excited about this program is because they know that people who exercise and remain socially connected actually cost the healthcare system less. So, they're happy to foot the bill for that gym visit because individuals who care for themselves through exercise and human connection are significantly healthier.
Prognostications for the future as it relates to our current state of health and health marketing?
Long-term I think the great challenge with the pandemic is that it’s particularly isolating for those of a higher risk class who are now shut in. And it's affecting the young and those who are 65 and older as well in ways we've never imagined. I think beyond the pandemic the great challenge that we'll have is the behavioral health crisis that's affecting our country.
So you think about brand and demand as it relates to mental wellness, and how to get people to change their mindset around their experience of life? Somebody made a lovely comment recently that hopefully, like in the roaring twenties, we'll experience a Renaissance in this country because almost everything has had to change: our behavior, our experiences, the way we think about going to work and school and experiencing play and exercise. But Americans in particular are remarkably resilient and creative and I think we'll find unique ways to reconnect again.
We need to use technology effectively, but I think the the companies that recognize, particularly in healthcare, that if they bring to life their brand’s value proposition and then create some sort of a demand structure that gets people to recognize its importance, again this combination of brand and demand, they'll win in the long-term. Consumers will win as well because they'll recognize the value that these brands are bringing, and we can live our lives in a healthier, better state.
Ed Note: You can hear the full interview as a podcast at Insider Interviews with E.B. Moss, Ep 22, or on YouTube:
February 1, 2021
